The diabetes epidemic is accelerating in the developing world, with an increasing proportion of affected people in younger age groups. Type 2 diabetes is characterised by relative insulin deficiency caused by pancreatic -cell dysfunction and insulin resistance in target organs. Type 2 diabetes is characterised by increased hyperinsulinaemia, insulin resistance, and pancreatic -cell failure, with up to 50% cell loss at diagnosis. Epidemiology of type 2 diabetes is affected by genetic and environmental factors. Genetic factors exert their effect following exposure to an obesogenic environment characterised by sedentary behaviour and excessive sugar and fat consumption. The main reasons for the current interest in screening for type 2 diabetes and the reasons why WHO and IDF convened this meeting are that there is a long, latent, asymptomatic period in which the condition can be detected, Ā the rising prevalence of type 2 diabetes world-wide and the seriousness of the immediate effects and long-term complications of type 2 diabetes.
Who is risk diabetes type 2?
- Family history of diabetes
- Overweight or obese
- Older age (45 years or older)
- High blood pressure
- High lipids (triglycerides and low HDL)
- Diabetes during pregnancy
- Sedentary life style/ physical inactivity
- Smoking
Performance of screening tests for type 2 diabetes:
1.Questionnaires
The CDC prediabetes screening test was revalidated in a national sample of US adults aged 18 years and older using 2007--2008 NHANES data. This screening test correctly identified 27%--50% of those with a score of 9 or higher as true cases of prediabetes based on the A1c, fasting blood glucose, or two-hour oral glucose tolerance confirmatory diagnostic tests..
2.Urine glucose
Having sugar in your urine is usually a sign of very high blood sugar levels. The extra sugar in the bloodstream is usually only removed via the kidneys at blood sugar concentrations of about 10 mmol/l (180 mg/dl) and above. In order to measure the amount of sugar in your urine, you need a urine test strip and a container for collecting urine. The usefulness of urinary glucose as a screening test for undiagnosed diabetes is limited because of the low sensitivity which ranged from 21% to 64% with specificity > 98% in studies which included performing an OGTT in the entire study population or a random sample of negative screenees.
3.Blood glucose
The current diagnostic criteria are the (venous) fasting plasma glucose (FPG) value is >= 7.0 mmol l-1 (126 mg/dl), or if the casual plasma glucose value is >= 11.1 mmol l -1 (200 mg/dl), or if the plasma glucose value 2 hours after a 75g oral load of glucose >= 11.1 mmol l-1 (200 mg/dl).
4.Glycated haemoglobin